Cultural Competency: Matters of Modesty

In an increasingly diverse, multicultural society, nurses are challenged to provide effective care to patients of all religions, races, and cultures. This three-part series will explore various aspects of culturally competent care in nursing practice.

Many cultures and religions place a high value on modesty, particularly for women, associating it with honor and virtue. Often modesty is linked to styles of dress and circumstances under which an individual might feel comfortable being uncovered or touched. Yet, there are personal reasons for modesty too, so you’re likely to come across patients, both male and female, who have firm boundaries of privacy—including survivors of sexual assault and transgender patients.

Modesty can be so important to some patients that medical visits cause them a great deal of stress and anxiety. Some will shop around for a clinician of a particular gender or one who makes them feel comfortable—or even forego care completely. As a nurse, your ethical commitment to patient advocacy and patient dignity requires you to demonstrate cultural sensitivity to patients who value modesty. Making accommodations for a patient who values modesty is a form of holistic care, because it recognizes the individual’s emotional well-being.

In general, nurses should always preserve patient privacy, by providing gowns and cover-ups, pulling drapes closed, knocking before entering an exam room, etc. Whenever possible, go the extra mile, by providing scrub pants if a gown doesn’t close in the back or double-gowning a patient who will be leaving his room. Patients may know intellectually that healthcare providers “have seen it all,” but that doesn’t stem their embarrassment. You can also urge your employer to build an environment where patients feel safe, by speaking up about gowns that don’t close all the way or other modesty issues.

Cross-cultural patient encounters can often be challenging in terms of modesty. Muslim women are likely to request female providers only, and these requests might be hard to honor in small facilities or rural areas. They may also prefer to have their husband present during an exam or procedure, and may resist disrobing entirely—or uncovering their hair—for an exam. Women from certain Asian cultures also have a strong preference for female obstetrics staff. Ideally, nurses should be able to anticipate cultural requirements for modesty and make accommodations before patients become anxious or uncomfortable.

While the majority of nurses are female, many mistakenly believe that male patients really don’t care about modesty, but that often is not true. Many hospitals don’t have nearly enough male nurses or technicians on staff, but you should try your best to honor requests for same-gender providers for baths, catheterizations, or other intimate procedures. Always try to be sensitive to modesty concerns—even when it creates an extra step for you or takes more time.

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